The World Bank pioneered global HIV and AIDS financing early in the emergency and remains committed to achieving Millennium Development Goal 6, to halt by 2015 and begin to reverse the spread of HIV and AIDS, through prevention, care, treatment, and mitigation services for those affected by HIV and AIDS.
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Ratings for the Great Lakes Initiative
on HIV/AIDS (GLIA) Support Project for Africa Region were as
follows: outcomes were moderately unsatisfactory; the risk
to development... Show More + outcome was significant; the Bank's
performance was moderately unsatisfactory; and the
Borrower's performance was moderately satisfactory.
Some lessons learned included: the main beneficiaries of
this regional project---refugees and long distance
truckers--- as well as the communities and individuals they
interact with were clearly the appropriate groups to target.
Addressing both the needs of mobile and vulnerable groups
and surrounding communities in an integrated manner avoids
creation of distortions. Ensuring activities funded are well
integrated into health district plans early on to promote
synergies and to facilitate continuity. Working with
existing regional institutions and beefing up their capacity
through an initial capacity building phase. Show Less -

The Project for the Multi-Sectoral
HIV/AIDS Project for Ghana will Reduce the new infection
among vulnerable groups and the general population; Mitigate
the impact o... Show More + f the epidemic on the health and socio-economic
systems as well as infected and affected persons; and
Promote healthy life-styles, especially in the area o f
sexual and reproductive health. Project components:
Component 1) covers laws and policies on rights of the
vulnerable groups operationalized. Component 2) will
strengthen national and decentralized levels to coordinate,
monitor and implement interventions. Component 3) aims for
positive socio-cultural practices and beliefs that help
reduce transmission identified and negative ones eliminated.
Component 4) aims at decreasing risky sexual behavior.
Component 5) will upscale treatment care and support.
Component 6) will provide periodic status, trends, and
changes in inputs, outputs and outcomes. Component 7) will
enhance resource mobilization. Show Less -

This paper is the first in a series of
efforts to document the current practices of CHBC in the
Multi-Country HIV/AIDS Program (MAP) for Africa, focusing on
the operational... Show More + challenges and limitations. In its design,
the MAP is unprecedented in its flexibility, coverage and
the emphasis it places on local, community-driven
initiatives responding to the HIV/AIDS crisis. Country
programs are designed to encompass all sectors and the full
range of HIV/AIDS prevention, care and treatment activities.
CHBC is an example of the community-driven initiatives
focusing on HIV/AIDS care and treatment activities. Research
shows that an effective and affordable CHBC for PLWHA, has
the potential to positively impact the health and social
status of patients, families and the community as a whole.
However, research has also shown that CHBC area facing a
multitude of challenges and limitations which not only
adversely affect their ability to carry out their
activities, but also have the potential to exacerbate
poverty and existing gender inequalities among affected
families and communities This research was conducted by
ACTafrica to find out the current operational challenges and
limitations faced by CHBC organizations, primarily CBOs, in
selected MAP countries: Burkina Faso, Cameroon, Malawi,
Mozambique, Nigeria, Senegal, Tanzania, Zambia. Show Less -

Foundation for Research on Women's
Health, Productivity and the Environment (BAFROW) is a local
women's Non-Governmental Organization (NGO) in The
Gambia that is considered... Show More + an example of best practice for
its holistic and community-based approach to the promotion
of healthy behavior, women's activities and the fight
against HIV/AIDS. A knowledge and learning team from the
Africa region's quality and knowledge department
visited the NGO in January 2003 and the BAFROW team shared
the lessons learned, the challenges encountered and the
successes they have encountered thus far. The debriefings
(video-taped open-ended interviews) on which this article is
based, included many prominent members and leaders of local
NGOs and HIV/AIDS projects. Show Less -

Surveillance systems in Uganda detect
that HIV prevalence declined from 21.1 percent in 1991 to
6.4 percent in 2001. The most common explanations for this
decrease are... Show More + that the population mobilized itself with the
consequence that more people were faithful to their
partners, or abstained from sexual contact, and used condoms
during sexual intercourse (Low-Beer et al 2003). Although
one might debate which of these behavior changes contributed
most to the apparent reduction in HIV prevalence, no one
would claim that Uganda can now become complacent about its
HIV/AIDS programs. Quite the contrary. National HIV/AIDS
Committees continue to have the responsibility for both
covering their populations with the highest quality
prevention, care, support, and treatment programs possible,
and to improve them constantly. Show Less -

This is a study of how well public
voluntary counseling and testing (VCT) programs for HIV/AIDS
reach poor people in township areas of Cape Town, South
Africa. The study... Show More + covered three public clinics, where lay
counselors from local nongovernmental organizations provided
counseling. A clinic nurse was responsible for testing and
notifying patients of the results. Waiting room interviews
of 540 patients included questions about the patients'
possessions and housing conditions designed to assess
economic status. This information was compared with
comparable information for people in South Africa as a
whole, and in South Africa's urban areas, collected
through a large-scale household Demographic and Health
Survey. The principal finding was a much higher use of VCT
services by lower- than higher-income patients. Almost 75
percent of VCT patients came from the poorest 40 percent of
South Africa's urban population, fewer than 10 percent
of patients belonging to the urban population's highest
40 percent. VCT patients were also poorer on average than
patients attending the clinics for other reasons. The study
also included focus group discussions with residents of the
townships where the clinics were located, designed to
determine what factors influence use of the clinics for VCT.
These suggest that an important reason for the predominance
of poor people among clinic patients was the poor reputation
of the services provided by the clinics. This led better-off
people to seek care from other, more expensive available sources. Show Less -

The principal objective of the review is
to assess: (i) the continuing viability and appropriateness
of the objectives, approach and design of the Multi-Country
HIV/AIDS... Show More + Program for Africa (MAP program), (ii) progress in
its implementation, and (iii) the effectiveness of the Bank,
and to draw lessons of experience to help guide preparation
of the future MAP program. Given the significant changes in
the overall environment for HIV/AIDS prevention, care and
treatment since 2000, the review team focused particularly
on recommendations for adaptation of the Program to enhance
its effectiveness. Principal conclusions of the review: the
objectives, approach and design of the MAP Program have
generally been appropriate. The original objectives are in
the process of being realized. Experience with
implementation of individual projects and sub-projects has
been mixed and often disappointing However, most projects
are new and need time to mature. The context for dealing
with the HIV/AIDS epidemic in Africa has changed
significantly since the program was launched in 2000.
Consequently, the future MAP program will need to become
more strategic, collaborative and evidence-based. Show Less -

The AIDS epidemic has emerged as a
devastating global crisis that continues to worsen and has
become a major obstacle to economic and social development.
So important... Show More + is this issue that an eminent group of
economists recently concluded that dealing with it is the
number one priority among the ten most important global
issues, not only for humanitarian reasons, but even from a
purely cost/benefit point of view. As part of continuing
efforts by the United Nations to better assist countries as
they intensify their national AIDS responses and allocate
financial resources accordingly, the World Bank and UNAIDS
organized a seminar in Geneva in June 2004 to examine
lessons learned from global best practices in four countries
implementing effective campaigns against HIV/AIDS. The
purpose of the seminar was to compare lessons from the field
and share that knowledge with people from countries that are
dealing with the difficult choices that need to be made when
tackling the epidemic. The seminar engaged in a
cross-country analysis of national responses, conceptualized
and implemented in entirely different social, cultural,
political and economic settings, to identify common policies
and practices in dealing with the HIV epidemic.
Representatives from the participating countries - Brazil,
Senegal, Uganda and Thailand - spoke openly of their
successes and failures and made recommendations that could
prove useful to other practitioners facing similar
situations. In light of their varied country profiles, the
lessons learned may not necessarily be applicable to all
countries, but could serve as a basis for identifying
effective, evidence-based strategies. This paper presents
the common elements for success and the specific lessons
learned from the very active programs in the four countries.
It aims to support the sharing of information, the
cross-fertilization of ideas and possible application in
other countries. Show Less -

Southern Africa is particularly affected
by HIV/AIDS. The disease already has a major impact in the
economies in the region and especially on the mining sector,
which... Show More + is a key business driver. With funding from the
Canadian development agency CIDA, IFC has commissioned from
Golder Associates an HIV/AIDS Resource Guide for the mining
sector - a resource for developing stakeholder competency in
mining communities in Southern Africa. The Guide contains 23
intervention strategies that collectively comprise a
comprehensive workplace response. The Guide is an integral
tool of the IFC Against AIDS program, which was launched in
2000 as part of IFC's commitment to sustainable
development. The program helps clients understand the
multiple impacts of the disease and provides guidance for
corporate HIV/AIDS Action Plans. IFC's anti-AIDS
approach pays special attention to a company's specific
needs and resources, as well as existing corporate
experiences and good practices. Show Less -

Turning Bureaucrats into Warriors -
Preparing and Implementing Multi-sector HIV/AIDS Programs in
Africa is a Generic Operations Manual (GOM) that has been
prepared to... Show More + provide practical, timely, operational, and
relevant advice, lessons learned, and examples for those
involved in waging the war against the HIV-AIDS epidemic in
Africa. This GOM has three main audiences: (1) National AIDS
Councils and their implementing partners in the public
sector and civil society, across the sectors and from the
village to the national level; (2) external institutions
involved in assisting the preparation and implementation of
HIV/AIDS programs, including specialized agencies and donors
such as the World Bank; and (3) institutions and people
around the world who are more generally involved in the
practical aspects of enhancing the effectiveness and
efficiency of HIV/AIDS program implementation. While the GOM
includes chapters on program activities, the emphasis of
these chapters will be on preparation and implementation
experience as this becomes available over the next few
years, rather than on what programs in prevention, care and
treatment and mitigation work best when, where and for whom.
The GOM includes lessons learned and examples of good
practices and is meant as a living document to which
additional lessons and good practices can be added by
practitioners in real-time through: (1) an interactive
website; (2) meetings of practitioners; and (3) annual
country reviews. It may be especially appropriate for
countries preparing HIV/AIDS programs or expanding existing
programs since cross-country experience can help
implementing agencies in the public sector and civil society
which participate extensively and intensively in preparing
operational manuals. The GOM represents a generic set of
lessons learned that can be adapted for specific country and
beneficiary conditions. Thus it is applicable for both high
and low prevalence countries, for those with small and large
populations, for those in a conflict or post-conflict
situation as well as those with stable political
environments. These lessons contained in the GOM will evolve
with operational experience and time. Show Less -

The use of information and
communications technologies (ICT) complements other
information education and communications (IEC) campaigns
designed to reach youth. The... Show More + same technology re- sources
e-mail, CD-ROMs, listserves, and the World Wide Web. that
can link HIV/AIDS educators and activists around the world,
also hold great promise for reaching youth, who typically
embrace the use of technology for entertainment, learning,
and communication when given access to these resources. Show Less -

Burkina Faso has the second highest
HIV/AIDS infection rates in West Africa, with an overall HIV
prevalence rate of around 7.2 percent. A large number of
development... Show More + agencies are active in the fight against
HIV/AIDS. An innovative community driven scheme to the
epidemic was piloted under a recently completed Bank project
and is now being replicated under a follow up HIV/AIDS
Disaster Response Project. This brief describes the design
of this pilot scheme both in terms of process and content;
presents preliminary results; and identifies key lessons and
future challenges. Show Less -